State-level policies, demographics and behaviors associated with youth obesity

描述（由申请人提供）：从1980年到2000年，尽管有许多公共卫生干预措施旨在教育年轻人健康饮食和体育活动的好处，但美国青年肥胖症增加了两倍。在目睹针对其他公共卫生问题（如烟草、自行车头盔、安全带）的公共政策获得成功后，肥胖问题研究人员和政策制定者将政策作为一种干预工具加以推广。在过去的十年中，针对青少年肥胖的州法案和决议的数量大幅增加;然而，人们对这些政策是否对饮食，活动或BMI产生影响知之甚少。NHANES最近的一份报告显示，1999年至2006年期间，全国青年肥胖症的平均患病率没有显著增加。在几十年持续增长之后，没有变化表明，过去十年实施的政策可能产生积极影响。 在这项研究中，我们将使用多层次模型来研究州内和州际高中生的BMI和体重相关行为的趋势。然后，我们将研究研究州一级的高中政策和BMI和体重相关行为之间的关联。这项工作的数据将来自青年危险行为监测（YRBS）和学校健康计划和政策研究（SHPPS）。目的1：研究2001 - 07年青少年BMI时间趋势的州际差异，并确定导致异质性的人口统计学和行为变量。目的2：估计2001年至2007年期间与人口统计学和行为变化相关的青年BMI的州内变化比例。目标3：确定2000 - 2006年州一级营养和体育活动政策的变化是否与2007年青年营养和体育活动行为有关。目标4：确定2000 - 2006年州一级营养和体育活动相关政策的变化是否与2007年青少年BMI和肥胖患病率相关。 考虑到肥胖流行病对美国青年当前和未来健康的破坏性影响，令人惊讶的是，评估大规模政策影响的工作很少。据我们所知，这将是第一项将YRBS的数据与SHPPS的数据合并的研究，以评估国家政策对青少年体重相关行为和肥胖的影响。 公共卫生相关性：我们将研究影响高中的国家政策，以评估其对青少年行为和BMI的影响。这将是迄今为止关于这一主题的最全面的研究，并将推动肥胖政策研究领域的发展;这一领域有很大的潜力影响我们年轻人的健康，但才刚刚开始。

DESCRIPTION (provided by applicant): Obesity among youth tripled in the United States from 1980 to 2000 despite numerous public health interventions designed to educate youth about the benefits of a healthy diet and physical activity. After witnessing the success of public policy adoption targeting other public health issues (e.g. tobacco, bike helmets, seat belts) obesity researchers and policymakers have promoted policy as an intervention tool. The number of state bills and resolutions targeting youth obesity increased substantially in the past decade; however, very little is known about whether these policies have an effect on diet, activity, or BMI. A recent report from NHANES showed that there was no significant increase in average national prevalence of youth obesity between 1999 and 2006. This absence of change, after decades of consistent increases, suggests that policies implemented in the past decade could be having a positive effect. In this research we will use multi-level modeling to examine trends in BMI and weight-related behaviors in high school students within and across states. We will then examine associations between study state level policies for high schools and BMI and weight-related behaviors. Data for this work will be from the Youth Risk Behavior Surveillance (YRBS) and the School Health Programs and Policies Study (SHPPS). The Aims of the research are: Aim 1: To examine between-state differences in youth BMI time trends from 2001-07 and identify demographic and behavioral variables that contribute to the heterogeneity. Aim 2: To estimate the proportion of within-state changes in youth BMI from 2001-07 that is associated with demographic and behavioral changes. Aim 3: To determine if changes in state-level nutrition and physical activity policies from 2000-06 are associated with youth nutrition and physical activity behaviors in 2007. Aim 4: To determine if changes in state-level nutrition and physical activity related policies from 2000-06 are associated with youth BMI and obesity prevalence in 2007. Given the enormity of the destructive effects of the obesity epidemic on the current and future health of American youth, it is surprising that so little work has been done to evaluate the effects of large scale policies. To our knowledge, this will be the first study to merge data from the YRBS to that from SHPPS to estimate the impact of state-level policies on weight-related behaviors and obesity in youth. PUBLIC HEALTH RELEVANCE: We will study state policies effecting high schools to estimate their effects on adolescent behavior and BMI. This will be the most comprehensive study on this topic to date and will advance the field of obesity policy research; a field that has strong potential to impact the health of our youth, but has only just begun.